LeAnna Kaiser Human Resources Dr. Roselli 04/25/2011 U.S. Healthcare Reform Healthcare reform in the United States has been a topic of much heated debate since it was introduced in President Obama’s campaign. This discussion continued as its main bill passed in house and senate, finally being signed into law by President Obama on March 23, 2010. Truly, though, healthcare reform is a blanket title that covers several pieces of legislature, but the generally agreed upon ones are the Patient Protection and Affordable Care Act, and the Health Care and Education Reconciliation Act of 2010. Reviewing articles written over healthcare reform, several key issues come to the forefront. The history of healthcare in America, how it points to why healthcare reform is being passed now after many past failures, and the three main themes found in the legislation are some of the main topics being addressed by scholars regarding healthcare reform. History Government-sponsored healthcare and universal health care have had a long history of rejection in the United States. In his article “Good Health for America?” Martin Gorsky outlines some of the history detailing these rejections. In the early 20 th century, the first attempt at creating universal insurance laws failed. This, Gorsky argues, was mainly due to powerful interest groups and political structures. Germany had been the first to implement obligatory health coverage, and as World War I began, it was “depicted as an insidious German innovation fundamentally at odds with the American way.” During World War II, this picture would be continued with Nazi Germany. As time passed and the Cold War began, health care reform was also portrayed as a Communist ideal. During the era of the Roosevelt’s New Deal, there was support for statutory insurance, but he decided against pushing it in favor of the Social Security Bill. In 1939, 1943, and 1945 unsuccessful bills were brought forward and defeated (Gorsky and Jonas). Instead, by 1945 15.7 million people had private health insurance due to a booming labor market. Change slowly came

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as Medicare and Medicaid were implemented under President Johnson in the 1960s. “This was the point at which US health spending began its relentless upwards course, rising from 5.6 percent of GDP in 1966 to 8.1 percent in 1976 and reaching 13.2 percent in 1996” (Gorsky). Reagan and Clinton both unsuccessfully tried to fix the growing problems. Although pressure groups undoubtedly have much to do with the past failures of large-scale health care reform in America, the very structure of our government is partially to blame. The American Medical Association and private health insurance industry have done much to lobby against health care reform, but as Gorsky also points out: The key point is that the political institutions of the US tend to impede deep and contentious reforms. Indeed, the separation of powers between the executive, Congress and the Supreme Court was designed to provide checks and balances on over-mighty

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